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COM: Neuro (Exam I) > Lecture 1: Suerficial Triangles& Cervical Viscera > Flashcards

Lecture 1: Suerficial Triangles& Cervical Viscera Flashcards

1
Q

What muscles does the spinal accessory nerve innervate?

A

SCM and Trapezius

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2
Q

What are the functions of the SCM?

A

Lateral flexion with rotation

Extension at Atlanto-occipital joints

Flexion of cervical vertebrae when person is supine

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3
Q

What is muscular torticollis?

A

“Wry neck” can be congenital or caused by muscular or nerve injury -> SCM affected! Most frequently caused by birth trauma

  • Benign fibrous tumor may accompany the condition -> termed fibromatosis Colli and typically resolves with physical therapy
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4
Q

What are the 5 fascial layers of the neck?

A 
Superficial fascia (fat, CT)
Investing layer
Pretracheal layer
Prevertebral layer
Alar fascia and carotid sheath
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5
Q

What is considered “zone 1” of the neck?

A

The horizontal area between the clavicle/suprasternal notch and the cricoid cartilage encompassing the thoracic outlet structures including the cupola of hte lung

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6
Q

What structures are all located in zone 1 of the neck and are at risk of being damaged in penetrating trauma?

A 
Proximal common carotid a
Vertebral a
Subclavian a
Trachea
Esophagus 
Thoracic duct 
Thymus
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7
Q

What is considered “zone II” of the neck?

A

Area between the cricoid cartilage and the angle of the mandible

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8
Q

What structures are found in zone II of the neck and are at risk of being injured in penetrating trauma?

A 
Internal and external carotid arteries 
Jugular veins
Pharynx
Larynx
Esophagus 
Recurrent laryngeal nerve 
Spinal cord
Trachea
Thyroid
Parathyroids
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9
Q

What is considered “zone III” of the neck?

A

Area that lies between the angle of the mandible and the base of the skull

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10
Q

What structures are found in zone III of the neck and at risk of being injured in penetrating trauma?

A

Distal extracranial carotid and vertebral arteries

Uppermost segments of the jugular veins

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11
Q

What 2 veins of the neck join to form the retromandibular vein?

A

Superficial temporal vein and maxillary vein

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12
Q

The retromandicular vein divides into a posterior and anterior division, What does each give rise to?

A

Anterior division -> facial and common facial veins

Posterior division -> posterior auricular vein and external jugular vein

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13
Q

What cutaneous nerves of the neck arise from erb’s point and what are their respective vertebral segments?

A

Lesser occipital -> C2
Great Auricular -> C2, C3
Transverse cervical -> C2, C3
Supraclavicular -> C3, C4

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14
Q

What nerve is always found sitting on the anterior scalene?

A

Phrenic nerve

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15
Q

What spinal segments give rise to the phrenic nerve?

A

C3, 4, 5 keep the diaphragm alive

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16
Q

What muscles does C1 provide?

A

Geniohyoid m

Thyrohyoid m

  • Then gives rise to superior root of ansa cervicalis
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17
Q

What muscles do the ansa cervicalis nerves supply?

A

Superior and Inferior belly of omohyoid

Sternohyoid

Sternothyroid

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18
Q

Name the suprahyoid muscles

A

Mylohyoid
Geniohyoid
Digastrics

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19
Q

What is the function of the mylohyoid muscle?

A

Elevate hyoid and tongue

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20
Q

What is the function of the geniohyoid muscle?

A

Shorten mouth floor

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21
Q

What is the function of the digastric muscle

A

Depress mandible and steady hyoid

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22
Q

Name the infrahyoid muscles

A

Sternohyoid
Omohyoid
Sternothyroid
Thyrohyoid

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23
Q

What is the function of the sternohyoid muscle?

A

Depress and steady hyoid

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24
Q

What is the function of the omohyoid muscle?

A

Depress and steady hyoid

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25
Q

What is the function of the sternothyroid muscle?

A

Depress hyoid and larynx

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26
Q

What is the function of the thyrohyoid muscle?

A

Depress hyoid and elevate larynx

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27
Q

What nerve innervates the mylohyoid muscle?

A

Nerve to mylohyoid from inferior alveolar n -> trigeminal

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28
Q

What nerve innervates the geniohyoid muscle?

A

C1 via the hypoglossal n

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29
Q

What nerve innervates the digastric muscle?

A

Anterior portion = mandibular division of trigeminal

Posterior portion = facial n

30
Q

What nerve innervates the sternohyoid muscle?

A

Ansa cervicalis

31
Q

What nerve innervates the omohyoid muscle?

A

Ansa cervicalis

32
Q

What nerve innervates the sternothyroid muscle?

A

Ansa cervicalis

33
Q

What nerve innervates the thyrohyoid muscle?

A

C1 via the hypoglossal n.

34
Q

What are the functions of the middle and posterior scalene muscles?

A

Flex neck laterally and elevate 2nd rib

35
Q

What is the thoracic outlet?

A

The space between the clavicle and your first rib; this narrow passageway is crowded with blood vessels, nerves and muscles

36
Q

What are the types and symptoms of each type of thoracic outlet syndrome?

A

Neurogenic -> numbness of limb, pain and weakness

Vascular -> weak pulse, blood clots, pallor and coldness

Nonspecific type -> pain in region

37
Q

What are causes of thoracic outlet syndrome?

A

Poor posture and repetitive use

38
Q

What are treatment options for thoracic outlet syndrome?

A

Physical therapy and surgery

39
Q

What is an ectopic thyroid?

A

Presence of thyroid tissue in locations other than the normal anterior neck region between the second and fourth tracheal cartilages

Most frequent form of thyroid dysgenesis

40
Q

What is the name of a small unpaired artery that 10% of people have that ascends on the anterior surface of the trachea and continues to the thyroid isthmus so it needs to be considered before tracheotomy?

A

Thyroid Ima Artery

41
Q

What is typically the point of entry to the venous system for central line placement, such as a pulmonary artery catheter?

A

Right and left subclavian vein

42
Q

A needle or catheter may be inserted in the internal jugular vein for diagnostic or therapeutic purposes. Which internal jugular vein is preferred and why?

A

The right because its usually larger and straighter

43
Q

How do you know where to insert a needle or catheter into the internal jugular vein?

A

Palpate the common carotid artery and insert the needle into the internal jugular vein just lateral to it at a 30 degree angle

44
Q

What cranial nerves are affected in Collet-Sicard syndrome?

A

9-12

45
Q

What cranial nerves are affected in Vernet syndrome?

A

9-11

46
Q

At what vertebra level is the cricoid cartilage?

A

C6

47
Q

What is found in layer 1 of the lateral neck?

A

Platysma m

External jugular vein

48
Q

What structures are found in layer 2 of the lateral neck?

A

SCM

Spinal accessory nerve (XI)

49
Q

What structures are found in layer 3 of the lateral neck?

A 
Ansa cervicalis (sup and inf roots)
Superior & inferior omohyoid m
Sternohyoid m
Sternothyroid m
Thyrohyoid m
50
Q

What are the boundaries of the posterior triangle of the neck?

A

Clavicle
SCM
Trapezius

51
Q

The superior salivatory nucleus sends _______________ fibers to the _______________ ganglion

A

Preganglionic fibers; submandibular ganglion

52
Q

The superior salivatory nucleus sends preganglionic fibers to the submandibular ganglion. Postganglionic parasympathetic axons from the submandibular gangion will then innervate what salivary glands?

A

Submandibular and sublingual

53
Q

The facial plexus on the facial artery distributes _____________ sympathetic fibers to the ___________ and _____________ salivary glands

A

Postganglionic sympathetic fibers; submandibular and sublingual salivary glands

54
Q

What nerve must you be sure not to cut during a thyroidectomy and what is a symptom that results from doing so?

A

Recurrent laryngeal nerve; hoarse voice

55
Q

What is the platysma?

A

A broad, fan-like muscle that originates across the upper shoulders and chest region and inserts along the lower border of the mandible and the region around the mouth.

It is superficial to investing fascia and forms part of the roof of the anterior and posterior triangles

56
Q

What effect does contraction of the platysma have on venous pressure?

A

It increases compartment size of the neck, thereby relieving underlying venous pressure

57
Q

What forms the roof and floor of the posterior (lateral) triangle of the neck?

A

Roof = platysma and investing fascia

Floor = prevertebral fascia

58
Q

What vein courses superficiallya Nd inferiorly across the SCM, and enters the posterior triangle deep to the platysma, where it drains into the subclavian vein?

A

External jugular vein

59
Q

Where is Erb’s point located?

A

On the posterior edge of the mid-point of the SCM

  • C5-C6 nerve roots of the brachial plexus and superficial cervical nerves (4 of them) are located at this point
  • Spinal accessory nerve is located about 1 cm above this point
60
Q

What do penetrating injuries to the area of Erb’s point result in?

A

Erb’s palsy (“waiter’s tip”)
XI (spinal accessory) palsy
Anesthesia of the skin of the neck or upper chest/shoulders

61
Q

Usually the transverse cervical vessels are readily foudn just anterior to what muscle?

A

Trapezius

62
Q

During dissection, you should use the transverse cervical artery to guide you to what 3 structures?

A

Phrenic nerve
Anterior scalene muscle
Thyrocervical trunk

63
Q

What vein and nerve are found anterior to the anterior scalene muscle?

A

Subclavian vein

Phrenic nerve -> immediately posterior to subclavian vein so its sandwiched between the muscle and vein

64
Q

What 2 structures are found just posterior to the anterior scalene muscle in the interscalene triangle, which is formed y the anterior and middle scalene muscles?

A

Subclavian artery

Brachial plexus

65
Q

What 3 structures are found within the carotid sheath?

A

Common carotid artery
Internal jugular vein
Vagus nerve

66
Q

What is immediately dep to the common carotid artery and embedded in prevertebral fascia and you should be aware of if you remove the carotid sheath?

A

Cervical sympathetic chain

67
Q

What vein is foudn superficial to the submandibular gland?

A

Facial vein -> this is used to locate the facial artery just adjacent

68
Q

The mandibular branch of the facial nerve is present in about 20% of people. Surgical compromise of this branch results in paralysis of what structures?

A

The depressors of the lower lip and angle

69
Q

What 3 structures are immediately posterior to the mylohyoid m and under the “ledge” of the mandible?

A

Submandibular duct
Lingual nerve
Submandibular ganglion

70
Q

Superficially, what 3 structures cover the submandibular gland?

A

Platysma
Facial vein
Marginal branch of VII

71
Q

The ___________ nerve is located just behind the 3rd molar between the medial pterygoid and the mandible. Between the mylohyoid and hyoglossus m, it spirals around the submandibular duct in a superolateral to inferomedial direction

A

Lingual nerve

COM: Neuro (Exam I) (13 decks)

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